Published Wed, 2011-09-07 17:43; updated 34 weeks ago.
Former Health Secretary Andy Burnham has defended his backing of the now-defunct "annual health check" for hospitals, despite admitting it was "a very blunt instrument" for measuring quality of care and having been advised it was considered "meaningless" by clinicians.
In his statement to the Inquiry, Mr Burnham had described the AHC as a "rigorous assessment" of NHS trusts.
But Tom Kark QC, counsel to the Inquiry, asked: "Do you accept that the annual health check was, in reality, a very blunt instrument and inaccurate if the purpose was to give any sort of assessment of the quality of services provided by a trust?"
Mr Burnham, who was appointed a health minister in 2006 and three years later became Health Secretary in Gordon Brown's government, conceded he did, adding: "I think...the placing of one label on an organisation when it came to quality of service, be that poor, acceptable, fair or good...would never capture the full range of what went on within a hospital, and that was something that I became more and more clear about the longer I was a health minister."
However, it was the first time the public had been able to "look at how their hospital was performing in relation to others".
Mr Kark interjected: "Performing in what sense? What does that mean? If you accept that it's too blunt an instrument and it can't give an accurate guide to what's going on in a hospital, how does it give people a guide to how a hospital is performing?"
Mr Burnham replied: "I think I'm recognising the limitations to the system that was introduced. But what I'm trying to say is that you have to see this as a journey. There was something of a quality journey taking place in the NHS at this time. There was no system at all prior to the star rating system, and that was an attempt for the first time to give an independent assessment of each hospital, so that that would be used then as a means by which improvement would be driven."
As a member of the Health Select Committee that looked at the star rating system – which preceded the AHC – he remembered "making criticisms of it, very similar to the ones you've just put to me". But, he insisted, it was an "unfolding journey within the National Health Service where we were using more data, getting better at analysing data, presenting it to the public in a meaningful way and then allowing people to use that data to hold local hospitals to account."
But Mr Kark continued: "You say it was meaningful. Can I just remind you of a piece of evidence that we have heard. It's an email from Professor David Haslam, writing to Nick Bishop of the HCC (Healthcare Commission), dated 29 October 2008...'My particular personal concern remains that on the whole, the AHC is meaningless to clinicians. Those in primary care don't use it and those in secondary care don't recognise it'."
Sir Ian Kennedy, then chair of the HCC, told Day 77 of the Inquiry "that he had made repeated attempts to have the (wording of the) core standards changed to something more meaningful but he was unable to do so and the resistance that he was meeting was from the Department of Health".
Mr Burnham, who lost his job when Labour was defeated in the 2010 General Election, said: "I remember having the discussion with Ian and there was around this time talk about how we were further going to change the way in which the regulators operated, and there was early talk about bringing the regulators together. So this was a moving picture. From my point of view, as a minister, I never had a closed mind when somebody of Ian's stature would bring something to me. But, yes, you are right, there was a feeling in the Department that that his concerns were not right. But, you know, as a minister we're there to try and adjudicate between those different points of view."
Earlier, Mr Burnham told the Inquiry that the "shocking, terrible events" at Stafford Hospital "will forever be etched on my mind".
He continued: "I feel very sorry for what the families have been through, what they continue to go through. I just wanted to make it clear...at the beginning that I am here to help the inquiry in whatever way I can to understand why these events happened and so that we can all ensure there is no repeat of failure on this scale in the National Health Service."
- The Inquiry resumed on Wednesday 7 September